Onkológia 5/2008

RADIOTHERAPY PROSTATE CANCER

Radiotherapy, radical prostatectomy, watchful waiting and hormonal therapy are the basic treatment modalities for prostate cancer. External beam radiotherapy and brachytherapy alone or in combination with other means of treatment represents curative option for nonmetastatic disease. Conformal radiotherapy improves toxicity profile by reduction of volumes of irradiated normal tissues. Conformal radiotherapy planning is based on extensive clinical research and is well understood and standardized. There are some unresolved questions and controversies in prostate cancer radiotherapy. The most predominant are as follows: long term treatment outcomes with prostatectomy versus modern radiotherapy, the clinical value of intensity modulated radiotherapy and target localization, dose escalation in various prognostic groups, optimal fractionation in presumed low α/β ratio, volumes to be irradiated, mainly the role of pelvic irradiation, timing and duration of androgen deprivation therapy in various risk groups, indication of postoperative and salvage radiotherapy and relative efficacy of brachytherapy.

Keywords: prostate cancer, radiotherapy, androgen deprivation